Junior RCM Officer

Fakeeh University Hospital; Dubai; On-site; AED 140,000 - 200,000; Full time

Job summary

Fakeeh University Hospital in Dubai is seeking a Pre-Authorization Specialist to review and process requests, verify insurance eligibility, and determine coverage based on policy criteria.

You will communicate decisions to providers and patients, maintain audit-ready documentation, and collaborate with claims and billing teams to ensure seamless submissions.

Qualifications

• Candidates must have 2–3 years of proven clinical experience in pre-authorization, insurance verification, or a related field in a healthcare setting.

Responsibilities

• Reviews and processes pre-authorization requests from healthcare providers to determine coverage.
• Verifies patient details and insurance eligibility for all pre-authorization requests.
• Communicates approval or rejection decisions to healthcare providers and patients based on established criteria.
• Maintains records of all processed requests and ensures documentation for audits; works with claims and billing to align approvals with claims submissions.

Skills

Pre-authorization

Insurance verification

Healthcare documentation

Auditing

Education

Bachelor’s degree in healthcare or business administration

Tools

EMR software

Claims systems

Job description

KEY RESPONSIBILITIES AND DUTIES:

Reviews and processes pre-authorization requests from healthcare providers (hospitals, laboratories, pharmacies) to determine if services are covered. Verifies patient details and insurance eligibility for all pre-authorization requests. Communicates approval or rejection decisions to healthcare providers and patients based on pre-established criteria. Reviews medical documentation submitted with pre-authorization requests to confirm the medical necessity and compliance with insurance policies. Maintains accurate records of all processed pre-authorization requests and ensures proper documentation for audits. Resolves issues with incomplete or incorrect information related to pre-authorization requests. Works closely with the claims and billing departments to ensure that pre-authorization approvals are aligned with the submission of insurance claims. Responds to inquiries from patients, providers, and internal stakeholders regarding the status of pre-authorization requests.

Additional Requirements

Candidates MUST have proven clinical experience in Pre-Authorization, Insurance Verifcation or a related field in a healthcare setting for 2 -3 years. Bachelor’s degree in a relevant field healthcare, business administration, or equivalent 2-3 years hospital/clinic experience in GCCArabic Speaker will be an advantage